2 Benefits of Inpatient Cardiac Rehab Ambulation speeds recovery of CV Surgery patients. Decreases depression and anxiety of patients Decreases stress and anxiety of families Decreases length of stay (LOS) Floor nurses greatly appreciate Cardiac Rehab assistance. Education provides patients & families with additional explanations of the entire hospital experience. For those patients not able to attend an outpatient cardiac rehab program, the education provides them with the an introduction to a heart healthy lifestyle. Education reduces the re-admission rate for MI patients. Not in ACSM guidelines for terminating exercise Getting Approval for Inpatient CR Billing at Lexington Medical Center When I first met with our Director of Audit and Compliance, he said that Inpatient CR billing was not allowed by Medicare. I told him that it was approved by Medicare in other parts of the country (Texas & Wisconsin). He asked for proof. I presented information from several other hospitals that had a history of billing for it. He was surprised and very interested, and asked me to find something from federal government supporting it. 2

3 Getting Approval cont. I presented him the report conducted by the OIG, at the request of CMS, that audited 34 cardiac rehab programs across the country, in the early 2000 s. This audit was primarily focused on the issues of Physician Supervision and the Incident To requirements. However, on page 2 of the Introduction, they made a statement concerning Phase I coverage by Medicare. Getting Approval cont. Phase I. Phase I begins in the acute convalescent period following a cardiac incident. This phase is considered part of the hospital stay and is covered under the Medicare diagnosis-related group allowance for the hospital stay. When our Director of Audit & Compliance saw this, he checked with some of his resources in SC. He then told me to proceed and we have been charging for inpatient since March, We have had a couple of denials, but these were non- STEMI patients listed as Observational patients. Aurora Health Care, Milwaukee, WI St. Luke s Medical Center They do approximately 1,500 cardiac surgeries annually. They bill 20,000 30,000 inpatient CR visits annually. In the early 2000 s, they were one of the first of 34 CR programs to be audited by the OIG at the request of CMS. The OIG was primarily reviewing physician supervision & incident to issues; however, they did review the inpatient program. The OIG (and CMS) found nothing wrong with their billing for inpatient CR. Sandra Zemke, RN Manager (414) Sandy has been there over 30 years and reports never having a problem. 3

6 Services Provided CV Surgery Patients I&A - We provide pre-admission (1-3 days) teaching for scheduled patients and spouses, and bed-side teaching for inpatients scheduled for CV surgery. Typically minutes. Surgery Family Consults After the family is escorted from the Surgical waiting area to the CVICU waiting room, we provide teaching to the family about what to expect during the ICU stay. (20-30 minutes) Services Provided CV Surgery Patients Progressive Exercise Starting 24 hours post-op, in CVICU, we begin progressive exercise. We see the patients twice a day and use a Swedish Walker for ambulation. We continue working with the patients until discharge or until they are able to ambulate a full lap of the telemetry floor (597 ), independently. We bill these in 15-minute units. The CVICU 6

11 Time to Smile Stressful Jobs? Think you have had a stressful day? Stressed Out? Most of us who work in cardiac and pulmonary rehab really love our work, which is to help patients with chronic diseases to live healthier lives. However, we all have those days when our jobs seem somewhat stressful. So, when you re feeling down and stressed out, just think about these workers 11

12 How would you like to work here? Enjoy working with your co-workers? I wonder what his heart rate is? 12

13 Is this considered strength training? Be Happy, Be Healthy, and Be Thankful! 13

CARDIAC REHABILITATION Follow-up Options & Dismissal Instructions Open Heart Surgery For patients of Jeffrey Kramer, MD As you re discharged from the hospital, you may have questions about your continuing

Liver surgery You will be having surgery to remove a tumour(s) from your liver. This handout will help you learn about the surgery, how to prepare for surgery and your care after surgery. Surgery can be

Family Caregiver Guide Planning for Inpatient Rehabilitation (Rehab) Services What Is Rehab? Many patients say that the transition (move) from a hospital or other care setting to rehab can be very confusing.

Comprehensive EHR Infrastructure Across the Health Care System The goal of the Administration and the Department of Health and Human Services to achieve an infrastructure for interoperable electronic health

CARDIAC REHABILITATION Winnipeg Region Annual Report 2013-14 PROGRAM OVERVIEW The Cardiac Rehabilitation Program (CRP) operates out of two medical fitness facilities in Winnipeg, the Reh- Fit Centre and

Medical Necessity & Charting Guidelines 1 In most cases we are told the rules up front - or will be told if we ask Like most games, the one who knows the rules the best WINS 4 2 Nationally Recognized Industry

The Centers for Medicare & Medicaid Services' Office of Research, Development, and Information (ORDI) strives to make information available to all. Nevertheless, portions of our files including charts,

GOING HOME AFTER YOUR TAVR PROCEDURE HENRY FORD HOSPITAL CENTER FOR STRUCTURAL HEART DISEASE GOING HOME After your TAVR procedure, you will need help when you go home. It is hard to predict how much help

Faculty Disclosures COPD Disease Management Tackling the Transition Dr. Cappelluti has no actual or potential conflicts of interest associated with this presentation. Jane Reardon has no actual or potential

Living Donor Liver Transplant An information guide for donors and recipients Table of Contents Page Number About Transplantation at Johns Hopkins 2 Liver Transplantation 2 Contact Us 2 Living Donor Transplant

BOWEL RESECTION Date of Surgery Please bring this booklet the day of your surgery. QHC#383 What is a Bowel Resection? A Bowel Resection is a surgical procedure in which a part of the large or small intestine

Pulmonary Rehab Program Services Web-Based Training February 25, 2010 - Q & As The following are the question and answers from the Pulmonary Rehabilitation Program Services web-based training which was

KIH Cardiac Rehabilitation Program For any further information Contact: +92-51-2870361-3, 2271154 Feedback@kih.com.pk What is Cardiac Rehabilitation Cardiac rehabilitation describes all measures used to

Epworth HealthCare Excellence. Everywhere. Everyday. What s your next step? The HeartSmart Program helping you to reduce your risk of another heart problem It has been clinically proven following a cardiac

Family Caregiver Guide For Family Caregivers: Leaving the Hospital and Going Where? Planning for care after a discharge is often stressful. A thoughtful discussion with a knowledgeable professional can

Cardiovascular Prevention and Rehabilitation Program Leading the way to a healthier heart For people who have had a heart attack, heart surgery or other cardiac event, or for those who have two or more

Quality Measures for Long-stay Residents Percent of residents whose need for help with daily activities has increased. This graph shows the percent of residents whose need for help doing basic daily tasks

Teaching physicians who accompany residents or review their notes and approve treatment plans must follow specific rules in terms of documentation and coding. Further, there are coding guidelines for physicians

American Diabetes Association Education Recognition Program Overview A brief history of the National Standards for Diabetes Self-Management Education and Support and a walk through the 10 DSME/S standards

What is an abdominal myomectomy? Surgical removal of fibroids through an abdominal incision-either up and down or bikini cut. The uterus and cervix are left in place. When is this surgery used? Treatment

We hope you enjoy this course. Most folks print a copy of the test and circle the answers while reading through the course. You can then log into your account (if you created one), enter your answers online,

Heartland Hospice Care Enriching life. We enrich lives right at home. At Heartland, we proudly provide hospice care wherever you call home: the house you ve lived in for decades, a skilled nursing center,

Preparing for your Total Hip or Knee Joint Replacement Pre-operative education for patients St. Clair Hospital Center for Orthopedics Copyright 2011 by St. Clair Hospital The Orthopedic Team Physicians

National Stroke Association s Guide to Choosing Stroke Rehabilitation Services Rehabilitation, often referred to as rehab, is an important part of stroke recovery. Through rehab, you: Re-learn basic skills

What do ACO s and Hospitals want from SNF s and CCRC s Presented to the Institute of Senior Living, April 11, 2013 A Division of Kindred Healthcare 1 Assessing the match: What hospitals and ACO s currently

OFFICE OF GROUP BENEFITS 2014 OFFICE OF GROUP BENEFITS CDHP PLAN FOR STATE OF LOUISIANA EMPLOYEES AND RETIREES PLAN AMENDMENT This Amendment is issued by the Plan Administrator for the Plan documents listed

Liz Cooke RN NP Quality of Life studies with HCT pts began at City of Hope in 1991 for Tool validation Retrospective Chart Review in 2000 of 100 HCT patients looking at readmission patterns. (published

The Expanding Role of the Nurse Practitioner and Physician Assistant Across the Continuum of Care for the CTS Patient: Preoperative, Postoperative, and After Discharge Jane MacIver RN NP PhD Peter Munk

Family Caregiver Guide Admission to Inpatient Rehabilitation (Rehab) Services What Is Rehab? Your family member may have been referred to rehab after being in a hospital due to acute (current) illness,

AACE Endocrine Coding Webinar Welcome to the Brave New World: Billing for Endocrine E & M Services in 2010 Question and Answer Submissions Q: If a patient returns after a year or so and takes excessive

What is excision of vaginal mesh? This procedure is done to remove mesh from the vagina. When is this surgery used? If mesh has eroded into the vagina, bladder, urethra, or bowel If there is pain associated

Cardiac Rehabilitation: From the other side of the glass door No disclosures, no conflicts Charles X. Kim, MD, FACC, ABVM Objectives 1. Illustrate common CV benefits of CV rehab in real world practice.

Cigna HealthSpring Premier (HMO POS) offered by Cigna HealthSpring Annual Notice of Changes for 2015 You are currently enrolled as a member of Cigna HealthSpring Premier (HMO POS). Next year, there will

Cardiac Rehabilitation: An Under-utilized Resource Making Patients Live Longer, Feel Better Marian Taylor, M.D. Medical University of South Carolina Director, Cardiac Rehabilitation I have no disclosures.

Preparing for Your Surgery Welcome As you get ready for surgery, you may have a lot of questions. This booklet will help you know what to expect before, during and after surgery. You and your family are

Having Surgery? What you need to know Questions to ask your doctor and your surgeon Agency for Healthcare Research and Quality Advancing Excellence in Health Care www.ahrq.gov This booklet was developed

WHAT IS MEDICAL MANAGEMENT? How health plans make decisions to approve payment for medical treatment is a poorly understood part of the healthcare system. One part of the process, known as medical management,

What is an abdominal surgery? Surgical removal of a mass or masses from the abdomen through an abdominal incision-either up and down or bikini cut. Why is this surgery used? To treat disease of the uterus,

TheraSphere A Radiation Treatment Option for Liver Cancer TheraSphere is a treatment which is done in the Interventional Radiology Clinic. If you have more questions after reading this handout, you can

Congratulations on your new hip! You are going home after a successful total hip replacement. Although there is still much work to do, we have already achieved a lot. So, when you get home, take a deep

X-Plain Preparing For Surgery Reference Summary Introduction More than 25 million surgical procedures are performed each year in the US. This reference summary will help you prepare for surgery. By understanding

PRE-OPERATIVE PATIENT INFORMATION Welcome to Memorial Hospital located in the beautiful White Mountains of New Hampshire. The following information is designed to provide you with information regarding

Prevention and Recognition of Obstetric Fistula Training Package Module 8: Pre-repair Care and Referral for Women with Obstetric Fistula Early detection and treatment If a woman has recently survived a

What is a total abdominal hysterectomy? Is the removal of the uterus and cervix through an abdominal incision (either an up and down or bikini cut). Removal of the ovaries and tubes depends on the patient.

Rehabilitation After Debilitation James Inzerillo MD Physiatrist What Happens to Me If I m I m Not Able to Take Care of Myself? Rehabilitation Options Self-Rehabilitation Outpatient Rehab At Home Rehab

Laparoscopic Gallbladder Surgery (Cholecystectomy) It is normal to have questions about your surgery. This handout gives you information about what will happen to you before, during and after your surgery.

Thoracic Surgery After Your Lung Surgery Patient Education Discharge Information You have just had lung surgery. The following are definitions of terms you may hear in connection with your surgery: THORACOTOMY

To ensure the functioning of the site, we use cookies. We share information about your activities on the site with our partners and Google partners: social networks and companies engaged in advertising and web analytics. For more information, see the Privacy Policy and Google Privacy &amp Terms.
Your consent to our cookies if you continue to use this website.